Eva Reichrtova

Cord serum immunoglobulin E related to the environmental contamination of human placentas with organochlorine compounds.

Allergic diseases are on the rise in both prevalence and severity, especially in industrialized countries. The process of allergic sensitization needs an understanding of the role environmental factors play in its development. In addition to traditionally considered air pollutants, various persistent organochlorine pollutants, which accumulate in the human body over a lifetime via food intake, are toxic in humans. Placental contamination by chemicals may act as a biologic marker for the exposure of the mother or for the fetus via transplacental transfer. Placentas were collected from term deliveries in two Slovak regions. The samples were then analyzed for 21 selected organochlorine compounds. Specimens of cord blood from 2,050 neonates were gathered for the determination of levels of total immunoglobulin E (IgE). The regions were chosen according to their environmental characteristics: a city polluted with organic chemical industry versus a rural region devoid of industrial sources of pollution. In addition, data regarding the incidence rate of atopic eczema cases in the regions were considered. Comparisons between regions revealed that both the placental contamination with 16 of 21 organochlorine compounds and the cord serum IgE levels were significantly higher in the industrial region. The findings pointed to an association between organochlorine compounds and the higher levels of total IgE in newborns, signaling a higher allergic sensitization in the industrial region. This association was supported by the higher incidence rate of atopic eczema cases in the population registered in the industrial region. ImagesFigure 1

Sites of lead and nickel accumulation in the placental tissue

1 There is a variety of quantitative analytical data regarding the total concentrations of heavy metals in human placentae. However, little is known about sites of metal accumulation in the placental tissue structural zones in relation to the environment. In this study, the lead and the nickel particulate deposits in the placental chorionic plate, the chorionic villous tree and the basal plate, using tissue histochemical reactions for lead and nickel, have been estimated. The degree of metal contamination of placentae was assessed according to an arbitrary scale. Both metals have shown a common mode of accumulation in the placental tissue structural zones. Among the observed contaminated structures in the placental tissue, the syncytiotrophoblast was the most frequent site for lead and nickel particulate deposits. 2 The frequency distribution of both metals within the mentioned placental zones, using four metal contamination degrees, was determined. A heavily contaminated zone was found to be the chorionic villous tree, especially in samples from the industrial region. 3 A comparison between two Slovak regions (an industrial and a rural one) using statistical tests was performed. The frequency of samples without any lead occurrence in the chorionic villous tree was found to be 10% in the industrial region, and 16% in the rural region. Regarding the nickel deposits, the frequency of non-contaminated samples in the industrial region was 2%, whereas in the rural region 6%. A relationship between traffic related pollution and human placenta contamination was found in both investigated regions.

Environmental and dietary risk factors for infantile atopic eczema among a Slovak birth cohort

Infantile atopic eczema (AE) is a risk marker for future asthma. This study assesses the contribution of modifiable exposures to infantile AE. If modifiable exposures contribute substantially to infantile AE, its prevention might be a sensible approach to asthma prevention. Pregnant women (n = 1978) were systematically recruited from maternity hospitals of the Slovak Republic; their birthed cohort of 1990 children were prospectively followed for 1 yr. Childrens exposures to selected environmental and dietary factors were assessed via maternal questionnaires administered at delivery and 1 yr of age. A child was considered to have AE, based on physical examination (SCORAD index >2) or mothers report of a previous physician diagnosis. Multivariate logistic regression was used to calculate adjusted odds ratios and percent total regression scores (TRS) for each variable. At 1 yr of age 1326 (67%) of the children remained in the cohort and 207 (15.6%) developed AE. Various modifiable environmental and dietary exposures increased the likelihood of AE (ownership of cats; consumption of infant formula, eggs, and fish) while others decreased the likelihood of AE (ownership of livestock; exclusive breast feeding for ≥4 months). Overall, modifiable exposures contributed less to the TRS than did non‐modifiable exposures (38% vs. 62%, respectively). The modifiable exposure category that contributed most to the TRS was infant feeding practices (27.5% TRS). Modifiable exposures – especially those related to infant feeding practices – significantly contribute to infantile AE, although modifiable factors contribute less overall than do non‐modifiable exposures.

Dynamics of allergy development during the first 5 years of life

Allergic diseases have increased in developed countries during the past decades. A cohort of Slovak children was followed from birth to track allergic symptoms dynamics in early childhood. Information on allergic symptoms (atopic dermatitis = AD, rhino conjunctivitis = RC, wheezing = Wh, urticaria = Ur) and food allergies among children was based on clinical evaluation of children by allergists at three developmental stages (infant, toddler, preschool). Out of 320 cases of allergies, 64 infants, 145 toddlers, and 195 preschool children suffered from AD, RC, Wh, Ur, or their combinations (i.e., significant increase with age, p < 0.001). AD first appeared in infants, Wh and/or RC rose mainly in toddlers, and Ur among preschool children. AD in infants or toddlers disappeared in the subsequent developmental stage in approximately one third of all cases. Single AD persistence without remission or extension was not common and accounted only for 6.9% of AD infants’ allergic manifestations. In addition to single-symptom allergic diseases, this study also identified several combinations of atopic symptoms.Conclusions: The proportion of multi-symptom allergies increased while single-symptom forms decreased. The observed temporal trends of allergic symptoms correspond to the atopic march.What is Known:• The observed temporal trends of allergic symptoms correspond to the atopic march.What is New:• Allergic diseases in children were first manifested as single forms, with atopic dermatitis (AD) commonly functioning as the “entry point” to allergies.• The overall proportion of single-symptom allergic disorders decreased over time while the proportion of multi-symptom allergies increased.